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General NPI Number Information
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NPI Number | 1952604654
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Entity Type | Individual
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Provider Name | ERIN O'CONNOR GRUPP LCSW, LCAS
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Gender | Female
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Dates
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Enumeration Date | 12/19/2010
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Last Update Date | 12/19/2010
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Provider Practice Location Address
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Address Line | 211 E SIX FORKS RD STE. 201
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City | RALEIGH
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State | NC
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Zip | 27609-7745
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Country | US
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Telephone | 919-244-4109
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Fax |
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Provider Business Mailing Address
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Address Line | 300 LAUREL SPRINGS DR #317
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City | DURHAM
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State | NC
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Zip | 27713-6714
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Country | US
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Telephone | 919-244-4109
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C007074
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License Number State | NC
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